Nov 20th, 2019 - Obstructive sleep apnea (OSA), also referred to as obstructive sleep apnea-hypopnea, is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep. Despite prevalence, OSA is often underrecognized and unde...
Nov 20th, 2019 - Obstructive sleep apnea (OSA) is an increasingly common chronic sleep disorder characterized by episodic narrowing and obstruction of the pharyngeal airway during sleep. The symptoms of OSA generally begin insidiously and are often present for years before the patient is referred for evaluation. Undiagnosed and untreated OSA places a significant burden on individuals affected by this disorder, ...
Brittany Urso, MD, Corey Georgesen, MD et. al.
Nov 20th, 2019 - To the Editor: Papulonecrotic tuberculid (PNT) is a cutaneous hypersensitivity reaction to antigenic components of Mycobacterium species, most commonly Mycobacterium tuberculosis. According to a PubMed search of articles indexed for MEDLINE using the terms papulonecrotic tuberculid, Mycobacterium avium complex, and Mycobacterium, only 1 case of PNT secondary to infection with Mycobacterium aviu.
Nov 20th, 2019 - NEW YORK – Seven years after the formation of the first pulmonary embolism response team (PERT), more than 100 institutions have joined the PERT Consortium, which was created to guide care and research for this thrombotic complication, according to a status report at a symposium on vascular and endovascular issues sponsored by the Cleveland Clinic Foundation. Ted Bosworth/MDedge News Dr.
Nov 19th, 2019 - A 2-day course of prophylactic antibiotic therapy can lower the risk of early ventilator-associated pneumonia (VAP) in cardiac arrest patients, a new study suggests. Investigators compared administration of amoxicillin-clavulanate vs placebo in adult patients on mechanical ventilation following out-of-hospital cardiac arrest and treated with targeted temperature management. Although fewer patie...
Nov 19th, 2019 - Idiopathic pulmonary fibrosis (IPF) and usual interstitial pneumonitis (UIP) are the most common forms of chronic, progressive fibrosing interstitial pneumonia of unknown origin. The clinical course of IPF is complicated and the prognosis is poor, with a median survival of 3-5 years from diagnosis. Although early diagnosis and treatment can relieve symptoms and slow disease progression, there i...
Nov 19th, 2019 - Do you know the ABCs of medication management for chronic obstructive pulmonary disease exacerbations? In the second episode of a two-part interview, Robert A. Wise, MD , outlines the evidence and best practices for treating patients with corticosteroids, and he discusses potential new approaches to preventing exacerbations.
Nov 19th, 2019 - Do you know the ABCs of medication management for chronic obstructive pulmonary disease exacerbations? Understanding how to effectively use the ABCs – antibiotics, bronchodilators, and corticosteroids – in COPD exacerbations can reduce morbidity and improve patient outcomes. In the first episode of a two-part interview, Robert A.
Nandan R. Hichkad, PA-C, MMSc
Nov 19th, 2019 - ANSWER The radiograph does not demonstrate any evidence of infiltrate or pleural effusion. However, of note is a rather large lytic lesion involving the posterior aspect of the right fourth rib.
Nov 14th, 2019 - A panel of the European Medicines Agency (EMA) has recommended solriamfetol (Sunosi, Jazz Pharmaceuticals) to improve wakefulness and reduce excessive daytime sleepiness (EDS) in adults with narcolepsy or obstructive sleep apnea (OSA) whose EDS has not been satisfactorily treated by primary OSA therapy, such as continuous positive airway pressure. Solriamfetol is a dual-acting dopamine and nore...
Nov 14th, 2019 - The inconsistent use of sex-specific reference ranges for transgender patients undergoing medical testing can change the way results are interpreted, investigators report. "Operators are not consistently using sex recorded at birth or gender identification reference ranges when performing spirometry tests for transgender patients," said Dinah Foer, MD, from Brigham and Women's Health in Boston....
Nov 14th, 2019 - The healthcare sector generates approximately 4.6% of global emissions, but physicians can shrink the carbon footprint and cut drug costs too by switching patients with asthma from a metered-dose inhaler (MDI) to one of the cheapest brands of dry powder inhalers (DPIs), researchers say. Using the National Health Service (NHS) digital database, Alexander J. K. Wilkinson, BMBCh, MRCP, a chest phy...
Naresh A. Dewan MD, FCCP
Nov 14th, 2019 - The conventional approach to treat hypoventilation has been to use noninvasive ventilation (NIV), while continuous positive airway pressure (CPAP) that does not augment alveolar ventilation improves gas exchange by maintaining upper airway patency and increasing functional residual capacity. Why, then, are we debating the use of CPAP vs NIV in the treatment of obesity hypoventilation syndrome (.
Nov 12th, 2019 - Interstitial lung disease (ILD), one of the most frequent manifestations of systemic sclerosis (SSc), or scleroderma, can be debilitating and may become life-threatening. Approximately 25 percent of SSc patients develop significant lung involvement within three years of diagnosis.
Nov 11th, 2019 - Vaginal delivery and breast-feeding diminish the incidence of allergy and asthma in children up to the age of 18 years, according to new research. "This is one of the largest cohorts of its kind in the country — it's a longitudinal study," said David Hill, MD, PhD, from the Children's Hospital of Philadelphia. "It's not a snapshot in time in a child's life." Hill and his colleagues compared the...
Nov 11th, 2019 - NEW ORLEANS – Smokers with pulmonary embolism (PE) are more likely to be readmitted to the hospital within 30 days of their index admission, according to a retrospective study. Dr.
MDedge Endocrinology; Mitchel L. Zoler
Nov 7th, 2019 - Diagnosis and treatment for obstructive sleep apnea resulted in medical cost savings in a group of U. S.
CHEST Physician; Jennifer Smith
Nov 7th, 2019 - NEW ORLEANS – A new analysis suggests dupilumab is beneficial for patients with early- or late-onset asthma. Dr.
MDedge ObGyn; E. Albert Reece, MD
Nov 5th, 2019 - We know that the environment significantly impacts our health. People who live in areas prone to industrial waste, poor air or water quality, and crime have higher risks for cardiovascular disease, severe asthma, and stress-induced illnesses.
Andrew D. Bowser
Nov 5th, 2019 - NEW ORLEANS – In patients with interstitial lung diseases at risk of pulmonary hypertension, inhaled nitric oxide produced meaningful improvements in activity that have been maintained over the long term, an investigator reported here. Inhaled nitric oxide, which improved moderate to vigorous physical activity by 34% versus placebo in an 8-week controlled trial, has demonstrated long-term maint.